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A rate com;lication of hysterectomy is complete prolapse and inversion of vagina. This can occur whether the hysterectomy was abdominal or vaginal and cystocele and/or enterocele is often associated with this condition. Traditionally, prolapse has been treated by surgery, the types of operation for prolapse are generally but not always, carried out through the vaginal rather than through the abdominal surgical route. We experienced five cases who had repair of posthysterectomy vaginal vault prolapse by transabdominal sacral colpopexy and report with brief review of literatures.
Cystocele ; Hernia ; Hysterectomy* ; Pelvic Organ Prolapse* ; Prolapse ; Vagina

Clinical investigation of 20 cases of brain abscess has been done at the dept of Pediatric Yonsei Medical Center, who had been treated during the period of 8 years from January 1977 through Jun 1985. Following results has been obtained: 1. Of 20 patients, 14 patient was male and the rest 6 was female rating M:F ratio 2.3:1 and the youngest patient was undler 1 year, the oldest one was 15 years old. 2. The chief complaints at admission were headache, fever, vomiting in order of frequency, while neurologic signs were neck stiffiness, hemiparesis, papilledema etc. 3. The preceeding causative diseases of brain abscess were diseases involving ENT 15%, congenital heart disease 20%, head trauma 35% and the rest 20% the etiology of brain abscess was not determined. The abscess tended to occure at temporoparietal area in the cases associated with otitis media while abscess originating from congenital heart diseases tended to occure multiple area. 4. 10 cases out of 20 had lumbar puncture under the suspision of meningitis, 2 cases manifested normal CSF finding. Patients who has focal neurologic finding associated with OMPC or congenital heart disease should suspect for brain abscess, which can be easily conform by brain C-T scan as well as patient who manifested unusual clinical course. 5. Factor relating prognosis were mental state and duriation between onset of clinical symptom and time starting treatment; clear mental state and short duration reflect better prognosis. 6. The motality rate was 33%, and the neurologic sequelas were hemiparesis (36.4%), mental deficit (18.2), dysarthria, epilepsy, hydrocephalus and blindness.
Abscess ; Adolescent ; Blindness ; Brain Abscess* ; Brain* ; Child* ; Craniocerebral Trauma ; Dysarthria ; Epilepsy ; Female ; Fever ; Headache ; Heart Defects, Congenital ; Heart Diseases ; Humans ; Hydrocephalus ; Male ; Meningitis ; Neck ; Neurologic Manifestations ; Otitis Media ; Papilledema ; Paresis ; Prognosis ; Spinal Puncture ; Vomiting

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The aim of this study was to clarify the role of Kupffer cells in the mechanism of endotoxin-induced liver injury. The study on fine structure of Kupffer cells was performed after the injection of endotoxin. The endotoxin(Escherichia soli lipopolysaccharide 026: B6, 1.5mg/100 g of body weight) was intraperitoneally injected in Sprague-Dewley rats. Animals were sacrificed at 1/4, 1/2, 1, 2, 4, 8, 16, 24, 72 and 120 hours after the injection of endotoxin. Livers were extirpated and processed to be examined by light and electron microscopy. The results obtained were summerized as follows: Early changes observed in liver after endotoxin injection included the increased number and hypertrophy of Kupffer cells, infiltration of neutrophils and presence of fibrin thrombi within the sinusoids. The coritinuous increase of the Kupffer cells in number with hypertrophy, congestion and infiltration of inflammatory cells within the sinusoids were observed. Hepatocytes showed* fatty change and occasional necrosis. At 72 hours the congestion decreased. At 120 hours the number of Kupffer cells was increased, but the morphology of Kupffer cells became similar to that of the control group. The numbers and sizes of primary and secondary lysosomes and amount of euchromatin of Kupffer cells increased. Swellings and increase in number of mitochondria, Golgi complex, smooth endoplasmic reticulum, rough endoplasmic reticulum were evident. Microthrombi were present within the sinusoids. The swelling of rough endoplasmic reticulum and mitochondria, decrease of glycogen particles, fatty change, hypoxic vacuoles, pyknotic nuclei and occasional necrosis were observed in hepatocytes. At 72 hours the number of secondary lysosomes in Kupffer cells decreased. At 120 hours the morphology of Kupffer cells became similar to that of the control group. According to these results, it was postulated that the endotoxin was initially taken up by pinocytosis into Kupffer cells and degraded in secondary lysosomes of activated Kupffer cells. Kupffer cells may play an important role in the defense mechanism of liver during endotoxemia. The dysfunction of Kupffer cells and ischemia by sinusoidal microthrombi may cause liver injury.
Animals ; Endoplasmic Reticulum, Rough ; Endoplasmic Reticulum, Smooth ; Endotoxemia ; Estrogens, Conjugated (USP) ; Euchromatin ; Fibrin ; Glycogen ; Golgi Apparatus ; Hepatocytes ; Hypertrophy ; Ischemia ; Kinetics* ; Kupffer Cells* ; Liver ; Lysosomes ; Microscopy, Electron ; Mitochondria ; Necrosis ; Neutrophils ; Pinocytosis ; Rats* ; Vacuoles